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Improve access to supplements to help prevent vitamin D deficiency

Wider availability of low-cost supplements could help prevent health problems in millions of people at risk of vitamin D deficiency, NICE says.

Latest public health guidance recommends increasing access to vitamin D supplements, and raising awareness of the health problems associated with it, to address those who may be at risk.

Vitamin D is important for keeping bones and teeth healthy. A lack of the vitamin can lead to deformities such as rickets in children, and a condition known as osteomalacia in adults which causes pain and tenderness.

In England, around a fifth of adults and a sixth of children – approximately 10 million people –may have low vitamin D status.

This is partly because the main source for vitamin D is from natural sunlight, and for 6 months of the year – from mid-October to the beginning of April – there is no sunlight at the correct wavelength for skin to create vitamin D.

Certain groups of people in the UK are also more likely to have lack of vitamin D. These include pregnant women, children and older adults. People with darker skin are also at risk of having low vitamin D levels.

While people from these groups are advised to take a vitamin supplements, they do not always receive the information and support they need. For example, there is low uptake of the Healthy Start scheme, which provides free vitamin D supplements to pregnant and breastfeeding women.

NICE’s latest public health guideline aims to increase the use of vitamin D supplements to prevent deficiency among those most at risk.

The guideline recommends that access to vitamin D supplements containing the recommended dose should be increased.

It calls for the Department of Health to work with manufacturers to ensure vitamin D supplements providing the recommended dose, are widely available for at risk groups.

Local authorities should ensure supplements containing the recommended dose of vitamin D are available at all at-risk groups, in settings such as pharmacies, children’s centres and GP reception areas.

In addition, local authorities should consider providing free supplements for at-risk groups, and encourage pharmacies and other outlets selling supplements to stock the lowest cost vitamin D supplements and promote them to those at risk.

The guideline also recommends that awareness of the importance of vitamin D supplements should be raised among local populations.

It calls for increased awareness of the importance of vitamin D for good health, good sources of vitamin in the UK, local sources of vitamin D such as Healthy Start, and sources of further information.

Professor Mike Kelly, Director of the NICE Centre for Public Health, said: “Around 10 million people in England may have low vitamin D status and so could be at risk of health problems – and they may not know it.

“People with darker skin are particularly at risk – during winter months nearly 75% of adults from Asian or African and Caribbean backgrounds may have low vitamin D levels. People who are over 65 years old are another group at risk of having low vitamin D levels, and so are also at risk of conditions like osteomalacia – soft bones.

“NICE recommends making low cost vitamin D supplements widely available to people at risk of deficiency.”

Professor Susan Jebb, Professor of Diet and Population Health at the University of Oxford, and Chair of the guideline development group, said: “This guidance is about preventing vitamin D deficiency by improving awareness of vitamin D deficiency through national activities and systems to enable people who are most at risk to take a vitamin D supplement.

“The NICE guidance says that clearer recommendations are needed from all organisations involved in tackling low vitamin D levels. For example, the uptake of Healthy Start supplements among pregnant and breastfeeding women and young children is reported to be less than 10%.

“Better availability of free or low cost supplements and promotion by health professionals during routine consultations could help increase uptake and improve the health of new mothers and their children.”

Dr Alison Tedstone, Chief Nutritionist at Public Health England, said: “Public Health England welcomes this new guidance from NICE which will help improve implementation of the current government advice on vitamin D.

“This guidance reiterates, and will help promote awareness of, the importance of vitamin D supplements for at-risk groups.”

Around 10 million people in England may have low vitamin D status and so could be at risk of health problems – and they may not know it.

Professor Mike Kelly, Director of the NICE Centre for Public Health

Better availability of free or low cost supplements and promotion by health professionals during routine consultations could help increase uptake and improve the health of new mothers and their childr

Professor Susan Jebb, Professor of Diet and Population Health at the University of Oxford